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Hello, Yesterday I Went To GP Regarding My Increased Rapid
Question: Hello,
Yesterday I went to GP regarding my increased rapid heart rate and not-well controlled hypertension. I am 29 years old male with obesity (BMI = 57). Having a resting heart rate around 85-90. And a blood pressure around 135/85. I have not AFib or any other similar arrhythmia confirmed by ECG.
I was using so far Nebivolol 5mg for many years, but now I felt it stopped working on my heart rate.
I was also using Perindoprilum 5mg for hypertension, but it seems it does not controlled it enough.
Yesterday I was put on Ivabradinum 5mg twice day for rapid heart rate and Pereindoprili/Indapamidum 10mg/2.5mg for hypertension.
Is this Ivabradinum 5mg twice daily a safe choice for lowering my rapid heart rate, instead of putting me on another betablocker? What do a cardiologist says about this?
Yesterday I went to GP regarding my increased rapid heart rate and not-well controlled hypertension. I am 29 years old male with obesity (BMI = 57). Having a resting heart rate around 85-90. And a blood pressure around 135/85. I have not AFib or any other similar arrhythmia confirmed by ECG.
I was using so far Nebivolol 5mg for many years, but now I felt it stopped working on my heart rate.
I was also using Perindoprilum 5mg for hypertension, but it seems it does not controlled it enough.
Yesterday I was put on Ivabradinum 5mg twice day for rapid heart rate and Pereindoprili/Indapamidum 10mg/2.5mg for hypertension.
Is this Ivabradinum 5mg twice daily a safe choice for lowering my rapid heart rate, instead of putting me on another betablocker? What do a cardiologist says about this?
Brief Answer:
Can have either of two
Detailed Answer:
Hello,
Either ivabradine or any beta blocker is fine. However, considering associated hypertension, beta blockers would have been a better choice as would have helped in both. Anyways, you may continue with ivabradine as well, which is equivalent to beta blockers.
Now, important thing is, all these problems hypertension and tachycardia is related to obesity. So, if you are able achieve weight loss then these will regress. Also, you should do regular exercises which will increase vagal tone and reduce your heart rate without medications. If you have obstructive sleep apnea symptoms like snoring, interuppted breathing at night then get it addressed as its a important cause for daytime tachycardia. Perindopril/ indapamide is fine for hypertension.
Hope this helps you and get back if you have any doubts.
Can have either of two
Detailed Answer:
Hello,
Either ivabradine or any beta blocker is fine. However, considering associated hypertension, beta blockers would have been a better choice as would have helped in both. Anyways, you may continue with ivabradine as well, which is equivalent to beta blockers.
Now, important thing is, all these problems hypertension and tachycardia is related to obesity. So, if you are able achieve weight loss then these will regress. Also, you should do regular exercises which will increase vagal tone and reduce your heart rate without medications. If you have obstructive sleep apnea symptoms like snoring, interuppted breathing at night then get it addressed as its a important cause for daytime tachycardia. Perindopril/ indapamide is fine for hypertension.
Hope this helps you and get back if you have any doubts.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for your fast reply, Dr XXXXXXX
I've been on Nebivolol for both hypertension and anxiety related issues since 2011. I was diagnosed with hypertension in my teen years already (it's genetic, my father passed away in early 40s due to heart disease). Then my weight was dramatically lower, much below 100kg as far as I remember. Then it started climbed up.. especially after starting Flupentixol 1mg daily for my anxiety issues. I gained 53kg in past two years! I understand that my eating and sedentary lifestyle is to blame, but could Flupentixol play a role as well? I could not tolerate SSRIs and hate the feeling being on them. I am also on a daily low-dose xanax..
I've been on Nebivolol for both hypertension and anxiety related issues since 2011. I was diagnosed with hypertension in my teen years already (it's genetic, my father passed away in early 40s due to heart disease). Then my weight was dramatically lower, much below 100kg as far as I remember. Then it started climbed up.. especially after starting Flupentixol 1mg daily for my anxiety issues. I gained 53kg in past two years! I understand that my eating and sedentary lifestyle is to blame, but could Flupentixol play a role as well? I could not tolerate SSRIs and hate the feeling being on them. I am also on a daily low-dose xanax..
Brief Answer:
May cause weight gain
Detailed Answer:
You are welcome..
Flupentixol may be responsible for weight gain in addition to other factors. You continue ivabradine and see its response.
Now, young hypertensive and overweight patients should get some investigations done to rule out treatable causes like thyroid profile, renal artery Doppler, serum cortisol and 24 hour urinary metanephrines. Sugars and lipid profile are also necessary. So, I guess, you already undergone all these tests and if not should request for these investigations.
May cause weight gain
Detailed Answer:
You are welcome..
Flupentixol may be responsible for weight gain in addition to other factors. You continue ivabradine and see its response.
Now, young hypertensive and overweight patients should get some investigations done to rule out treatable causes like thyroid profile, renal artery Doppler, serum cortisol and 24 hour urinary metanephrines. Sugars and lipid profile are also necessary. So, I guess, you already undergone all these tests and if not should request for these investigations.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Was it good idea to stop nebivolol suddenly and replacing it with ivabradine? I was on nebivolol since 2011. I feel my heart now pounding more.
Brief Answer:
Tapering would have been a better option
Detailed Answer:
Since you are on it for long duration, tapering would have been a better choice in order to minimize these effects which you are facing. If you are not able to tolerate it then you need to restart it and have gradual tapering. Otherwise these withdrawal symptoms should subside in a week or two. Since you are young and without any heart disease, this is unlikely to have any grave implications other than symptoms.
Tapering would have been a better option
Detailed Answer:
Since you are on it for long duration, tapering would have been a better choice in order to minimize these effects which you are facing. If you are not able to tolerate it then you need to restart it and have gradual tapering. Otherwise these withdrawal symptoms should subside in a week or two. Since you are young and without any heart disease, this is unlikely to have any grave implications other than symptoms.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks, I read so on internet that sudden stop is not good.
Can it be that over time it (nebivolol) loses its effect and I might need a higher dosage? Doctors says nebivolol is good for young man. How about metropolol and others?
Can it be that over time it (nebivolol) loses its effect and I might need a higher dosage? Doctors says nebivolol is good for young man. How about metropolol and others?
Brief Answer:
Not good especially in heart patients
Detailed Answer:
Sudden stoppage may give you some symptoms and in heart patients, it may actually be harmful. So, it's not recommended in elders and whose heart is compromised. In young individuals, its not that worrisome.
With time some amount of tolerance do occur with any medicine and may need bit higher doses. Also, it's possible that worsening of symptoms may be due to anxiety or disease exacerbations, which occurs intermittently.
There are minor differences among beta blockers and one may safely have metoprolol instead of nebivolol.
Not good especially in heart patients
Detailed Answer:
Sudden stoppage may give you some symptoms and in heart patients, it may actually be harmful. So, it's not recommended in elders and whose heart is compromised. In young individuals, its not that worrisome.
With time some amount of tolerance do occur with any medicine and may need bit higher doses. Also, it's possible that worsening of symptoms may be due to anxiety or disease exacerbations, which occurs intermittently.
There are minor differences among beta blockers and one may safely have metoprolol instead of nebivolol.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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